1. Strong
Communities
Raise Strong
Kids
Impetus for Community Action

2. “The solution of all
adult problems
tomorrow depends
in large measure
upon the way our
children grow up
today.”
~ Margaret Mead,
Anthropologist

3. “The solution of all adult
problems tomorrow
depends in large
measure upon the way
our children grow up
today.”
~ Margaret Mead,
Anthropologist

4. What Are ACEs?
Adverse Childhood Experiences
• Traumatic experiences in
childhood
• Sometimes referred to as
toxic stress or childhood
trauma

5. ACEs Often Last a Lifetime . . .
But They Don’t Have To
• Healing can occur
• The cycle can be
broken
• Safe, stable,
nurturing
relationships heal
parent and child

6. Quick Survey
Rate Your Awareness of the ACE Study:
- No Knowledge of ACE Research
- Some Knowledge
- More Than Most
- Expert

7. Complete ACE Questionnaire
• What does it make you think about?
• Keep in mind your thoughts as we present
the ACE Study

8. Two Categories of ACEs
1) Growing up (prior to age 18) in a
household with abuse:
• Recurrent physical abuse
• Recurrent emotional abuse
• Sexual abuse
• Emotional or physical neglect

11. What Do ACEs Look Like?

12. Two Categories of ACEs, cont.
2) Growing up with Household Dysfunction:
• Alcohol or drug abuser
• Incarcerated household
member.
• Someone chronically depressed,
suicidal, institutionalized or mentally ill.
• Mother being treated violently.
• One or no parents.

13. Why is This Important?
Because ACEs are:
• Surprisingly common
• Occur in clusters
• Basis for common public health problems
• Strong predictors of later social functioning,
well-being, health risks, disease, and death

14. Question
How do you see ACEs
manifested in kids and families
in your community?

15. How It All Started

16. How It All Started

17. “Turning Gold into Lead”

18. Study Participants
• 26,000 adults invited to participate;
17,337 accepted
• Solidly middle class
• Average age = 57

19. Demographics
Gender Female 54% Male 46%
Race White 74.8% Hispanic/Latino 11.2% Asian/Pacific
Islander 7.2% African-American 4.6% Other 1.9%
Age (years) 19-29 5.3% 30-39 9.8% 40-49 18.6%
50-59 19.9% 60 and over 46.4%
Education Not High School Graduate 7.2%
High School Graduate 17.6%
Some College 35.9%
College Graduate or Higher 39.3%

20. ACE Scores
• 1/3 of adults have an ACE score of 0
• Majority of adults with
ACE score of 0 have few,
if any, risk factors for
diseases that are common
causes of death in the US.

21. ACE Scores
• Women are 50% more likely than men to
have an ACE Score >5
• If any one ACE is present, there is 87%
chance at least one other ACE is present,
and a 50% chance of 3 others
• This combination makes ACEs the leading
determinant of the health and social
well-being of our nation

22. AZ Data
• Children – Natl. Children’s Health Survey
• Adults – St. Luke’s Health Survey

23. ACEs are Common
ACE Score Prevalence
0 33%
1 26%
2 16%
3 10%
4 or more 16%

24. Group Question:
Do you think ACEs
are common in
your community?
Why or why not?

25. Out of 100 People

26. All the world is full of suffering, it is also full of overcoming.
-Helen Keller

27. Aces are Interrelated, Self-Perpetuating,
& Have a Cumulative Stressor Effect
• Number of different categories of ACEs (ACE
score) - determine health outcomes, not
intensity or frequency of a single category
• Without interruption, ACEs
escalate across generations

28. Aces are interrelated, self-perpetuating,
& have a cumulative stressor effect
• Number of different categories of
ACEs (ACE score) - determine
health outcomes, not intensity or
frequency of a single category
• Without interruption, ACEs
escalate across generations

29. ACE’s are Highly Interrelated
Alcohol Abuse in the Home and the Risk of Other
Household Exposures During Childhood

30. • ACE score of 4 or more may result in multiple risk factors
for these diseases or the disease themselves
• ACE score of 6 or more may result in a 20 year decrease
in life expectancy

31. Evidence Suggests
• Many chronic diseases in adults are
determined decades earlier, by
experiences in childhood
• Risk factors/behaviors for these diseases
are initiated during childhood or
adolescence and continue into adult life.

32. Top 10 Risk Factors for
Death in USA
smoking
severe obesity
physical inactivity
depression
suicide attempt
alcoholism
illicit drug use
injected drug use
50+ sexual partners
history of STD

33. Top 10 Risk
Factors for
Death in USA
smoking
severe obesity
physical inactivity
depression
suicide attempt
alcoholism
illicit drug use
injected drug use
50+ sexual partners
history of STD

34. Life Long Physical, Mental &
Behavioral Outcomes of
ACEs
• Alcoholism & alcohol
abuse
• Chronic obstructive
pulmonary disease &
ischemic heart disease
• Depression
• Fetal death
• High risk sexual activity
• Illicit drug use
• Intimate partner violence
• Liver disease
• Obesity
• Sexually transmitted
disease
• Smoking
• Suicide attempts
• Unintended pregnancy
*** The higher the ACE Score,
the greater the incidence of co-
occurring conditions from this
list.

35. Lifelong physical, mental &
behavioral outcomes of ACEs
• Alcoholism & alcohol abuse
• Chronic obstructive pulmonary
disease & ischemic heart disease
• Depression
• Fetal death
• High risk sexual activity
• Illicit drug use
• Intimate partner violence
• Liver disease
• Obesity
• Sexually transmitted disease
• Smoking
• Suicide attempts
• Unintended pregnancy
“The ACE health outcomes read like
A “who’s who” list of the top major
health problems in the United States.”
Dr. Robert Anda
Co-principal researcher on the ACE
study

36. Dr. David McCollum, retired ED physician and co-founder of the Academy on Violence & Abuse
(organization aimed at health professionals - provides education and research on the effects of
violence and abuse on health).

37. Seeking to Cope
• Risk factors/behaviors
underlying adult diseases are
effective coping devices.
• What is viewed as a problem is
actually a solution to bad
experiences.
• Dismissing these coping devices
as “bad habits” or “self
destructive behavior” misses
their functionality.

38. Coping Solutions
• What are conventionally
viewed as Public Health
problems are often
personal solutions to
long concealed adverse
childhood experiences.

39. ACEs and Addiction
“It’s hard to get enough of
something that almost
works.”
ACE findings suggest that
a major factor, if not the
main factor, underlying
addiction is ACEs that
have not healed and are
concealed from awareness
by shame, secrecy, and
social taboo.

40. ACE findings suggest
that:
a major factor, if not the
main factor, underlying
addiction is
ACEs that have not
healed and are
concealed from
awareness by shame,
secrecy, and social
taboo.
“It’s hard to get enough
of something that
almost works.”

41. ADVERSE CHILDHOOD EXPERIENCE
Adverse Childhood
Experiences
• ACEs are the greatest single predictor for health,
attendance and behavior.
• ACEs are the second strongest predictor, after special
education status, for academic failure.
• The relationship between academic achievement and
health status appears much less related to income than
to ACEs.

42. ACEs in the
classroom
• ACEs are the greatest single predictor
for health, attendance and behavior.
• ACEs are the second strongest
predictor, after special education status,
for academic failure.
• The relationship between academic
achievement and health status appears
much less related to income than to
ACEs.

43. ACEs in the
classroom
• ACEs are the greatest single predictor
for health, attendance and behavior.
• ACEs are the second strongest
predictor, after special education status,
for academic failure.
• The relationship between academic
achievement and health status appears
much less related to income than to
ACEs.

44. ACE Pyramid

45. Jim Sporleder of Lincoln High School tried a new
approach with his students. Using a more
trauma sensitive approach, Mr. Sporleder and
staff changed the entire culture of the school.
ACEs in Action!

46. “Pyramid of Hope”
“Before we can get our students prepared for learning, we have to focus on their
wounds and history of failures”
Jim Sporleder (principal of Lincoln High School)

47. Design your own
“Pyramid of Hope”

48. 3 Things you should know
about Brain Development
• We are hard wired to
survive.
• Brain architecture is
established early in life.
• Healthy brain architecture is
the necessary foundation
required for optimal future
learning, behavior and
health.

49. 3 Core Concepts in Early Brain Development
Harvard Center for The Developing Child

50. 1.) Toxic Stress derails healthy development

51. 2.) “Serve and Return” Interaction shapes
brain circuitry.
Nurturing, responsive, and individualized interactions from birth build healthy
brain structure

52. 3.) Experiences Build Brain Architecture

54. Serve and Return
Nurturing, responsive, and
individualized interactions
from birth build healthy brain
structure.
serve and return

55. “Brain Hero”
• http://developingchild.harvard.edu/index.php/re

56. Stress and the Brain
Excessive and repeated stress:
(Neglect, violence, chaos, hostility,
unpredictability, rejection)
Causes disruption of brain architecture:
– Impairs cell growth
– Interferes with healthy neural circuits (fries
brain with overdose of stress hormones)

57. Stress and the Brain
Excessive and repeated stress:
• Neglect, Violence
• Chaos, unpredictability
• Hostility, rejection
Causes disruption of brain architecture:
• Impairs cell growth
• Interferes with healthy neural circuits
• Strains brain with overdose of stress
hormones

58. Toxic Stress
• Causes children to live in fight, flight or fright
(freeze) mode.
• Short attention span
• Struggle learning; fall behind in school
• Respond to world as constant danger
• Distrustful of adults
• Unable to develop healthy
peer relationships
• Feel failure, despair,
shame and frustration

59. • Causes children to live in
fight, flight or fright (freeze)
mode.
• Short attention span
• Struggle learning; fall behind in
school
• Respond to world as constant
danger
• Distrustful of adults
• Unable to develop healthy
peer relationships
• Feel failure, despair,
shame and frustration
Toxic Stress impacts
children in the
Following ways:

60. Toxic Stress
It is fact not opinion that “Toxic Stress/ACE’s”
has a severe impact on the brain development
and a person’s future. It is a strong predictor
with negative outcomes without the
intervention of a positive adult relationship(s).
You can choose not to accept the findings, but
you can’t deny them.
Stressed
Can’t:
Brains
• Respond
• Learn or
• Process effectively
Allow time to de-

61. “It is fact not opinion that “Toxic Stress/ACE’s” has a severe
impact on the brain development and a person’s future. It
is a strong predictor with negative outcomes without the
intervention of a positive adult relationship(s).”
Jim Sporleder
• Respond
• Learn
• Process
effectively

63. By adolescence, children
seek relief through:
• Drinking alcohol*
• Smoking tobacco
• Sexual promiscuity
• Using drugs*
• Overeating/eating disorders
• Delinquent behavior, violence
• High-risk sports, etc.
* Note: nicotine and methamphetamines are
anti-depressants

64. Behavior is Predictable
All behavior (both good and bad) has meaning
We need to look closely
at what preceded the
behavior
What happened
first that is causing this
behavior?

65. All behavior (both good and bad) has meaning
We need to ask ourselves what might be going
on going on beneath the surface.

66. What Does
This Look
Like?
Teen that is:
– Edgy, hot tempered
– Impulsive
– Hyper-vigilant

67. High Risk Teen Behaviors
• May not be the core problem
• They may be coping devices
• A way to feel safe or just feel better

68. Trauma and Ongoing Stress
in Infants and Toddlers
• Increased arousal, elevated stress
hormones and other biochemical changes
in the body and the brain, altering brain
development
• Long-term effects on physical, mental, and
emotional development

69. What Does This Look Like?
• Changes in eating or sleeping routines
• Changes in growth and development
• Changes in relationships
• Regressions in developmental abilities

70. Behaviors Associated with Early
Childhood Trauma
Ages 0 - 2
• Dysregulated eating, sleeping
patterns
• Developmental regression
• Irritability, sadness, anger
• Poor appetite; low weight
• Increased separation anxiety;
clinginess
NCTSN.org/earlychildhoodtrauma
Ages 3 - 6
• Increased aggression
• Somatic symptoms
• Sleep difficulties/nightmares
• Increased separation anxiety
• New fears
• Increased distractibility/high
activity level
• Increased withdrawal/apathy
• Developmental regression
• Repetitive talk/play about the
event
• Intrusive thoughts, memories,

71. The 4th
Vital Sign
• Respiration, heart rate, blood pressure and
relationships
• Behaviors are children’s means of expression
• Caregivers often unable to understand
connection between traumatic event and
children’s behaviors
• To heal, children need recognition and
understanding from their caregivers

72. Break

73. Adverse Childhood Experiences
vs. Smoking as an Adult
0
2
4
6
8
10
12
14
16
18
20
0 1 2 3 4-5 6 or more
ACE Score

74. Adverse Childhood Experiences
vs. Adult Alcoholism
0
2
4
6
8
10
12
14
16
18
%Alcoholic
ACE Score
0 1 2 3 >=4

75. ACE Score vs.
Intravenous Drug Use
0
0.5
1
1.5
2
2.5
3
3.5
%HaveInjectedDrugs
0 1 2 3 4 or more
ACE Score

76. Adverse Childhood ExperiencesAdverse Childhood Experiences
vs. Likelihood of > 50 Sexualvs. Likelihood of > 50 Sexual
PartnersPartners
0
1
2
3
4
AdjustedOddsRatio
0 1 2 3 4 or more
ACE Score

77. ACE Score vs. UnintendedACE Score vs. Unintended
Pregnancy or Elective AbortionPregnancy or Elective Abortion
0
10
20
30
40
50
60
70
80
%haveUnintendedPG,orAB
0 1 2 3 4 or more
ACE Score
Unintended Pregnancy
Elective Abortion

78. Childhood Experiences
Underlie Chronic Depression
0
10
20
30
40
50
60
70
80
%WithaLifetimeHistoryof
Depression
0 1 2 3 >=4
ACE Score
Women
Men

79. Childhood Experiences
Underlie Later Suicide
0
5
10
15
20
25
%AttemptingSuicide
ACE Score
0 1 2 3 >=4

80. ACE Score vs.
Serious Job Problems
0
2
4
6
8
10
12
14
16
18
%withJobProblems
0 1 2 3 4 or more
ACE Score

81. Health Care Costs
• $2.6 trillion in US (2010)
• Over 10 times amount spent in 1980
• 17.9% of the Gross Domestic Product
• AZ – $13.8 billion in 2010 - 18% GDP
• 75% of health spending is for chronic
diseases (heart disease, cancer, stroke, and
diabetes)

82. Reducing Costs
Research shows that just
asking about ACEs –
significantly decreases
doctor office visits and
costs.

83. Pay Now or Pay Later
• Pay now for programs proven to buffer the
stress, or pay later in rising health costs.
• “Early childhood investments of high
quality have a lasting effect.”
“$10 return on investment
for every $1 spent.”
(James Heckman, Noble Laureate, Economics)

84. Pay Now or Pay Later
• Pay now for programs proven to
buffer the stress, or pay later in
rising health costs.
• “Early childhood investments of
high quality have a lasting effect.”
“$10 return on investment
for every $1 spent.”
(James Heckman, Noble

85. Cost of Child Abuse
• 2012 CDC Report - one year confirmed costs:
$124 billion over lifetime of traumatized children

86. ACEsACEs are theare the Pipeline toPipeline to
PrisonPrison
• 1 in 104 American adults is behind bars
• 1 in 33 American adults is under correctional control
• 1 in 4 of the world’s inmates is in a US prison or jail
• 1 in 8 state employees works in corrections
• 1 in 14 state general fund dollars is spent on
corrections
HIGH COST, LOW RETURN: 1 in 2.3 inmates returns
to prison within 3 years of release
( - ACES TOO HIGH)

87. ACEsACEs are theare the Pipeline toPipeline to
PrisonPrison
• 1 in 104 American adults is behind bars
• 1 in 33 American adults is under correctional control
• 1 in 4 of the world’s inmates is in a US prison or jail
• 1 in 8 state employees works in corrections
• 1 in 14 state general fund dollars is spent on corrections
HIGH COST, LOW RETURN: 1 in 2.3 inmates returns
to prison within 3 years of release
( - ACES TOO HIGH)

91. Take Break Here?

92. View Video Here?
• Healing Neen and/or Trauma Sensitive
School video?

93. Our Challenge
• We can and must “immunize” kids against
the effects of ACEs.
• We can and must reduce the numbers of
ACEs for all children!

94. Caring Communities
Can Help Reduce ACEs

95. Examples of Caring
Communities Action
• Health Care - Center for Youth Wellness, San Francisco
• Education – Lincoln High, Walla Walla WA
• Medicine – Jefferson Co Public Health
• Communities – Tarpon Springs FL, Philadelphia Urban
ACEs
• Corrections - Alaska Family Violence
• Faith Community - CA
• Juvenile Justice

96. How Do
We Meet
the
Challenge?

97. Three Important Concepts
• Protective Factors
• Resilience
• Trauma-Informed Care

98. Protective Factors
• Increase health and well-being of children
and families
• Critical to success at home, work and
community

99. Resilience
• Ability to deal with life’s ups and downs
• Resilience Trumps ACEs

100. Trauma Informed Care
• Not “What’s wrong with you?”; instead
“What happened to you?”
• Symptoms (substance abuse, etc) are
adaptations to trauma
• Shift from “The denial
stops here.” to “The
recovery starts here.”

102. It Starts With You!
• Identify and understand the importance of
protective factors
• Utilize protective factors in your own life
• Empower others by educating and
encouraging them to use protective
factors

103. Parent Café Activity?

105. Protective Factors
• Conditions that increase health and well being
• Critical for everyone regardless of age, sex,
ethnicity or racial heritage, economic status,
special needs, or the dynamics of the family unit
• Buffers that provide support and coping
strategies

106. Protective Factors that Strengthen
Families and Communities
• Nurturing and Attachment
• Knowledge of Parenting
and Child Development
• Parental Resilience
• Social Connections
• Concrete Support in Time of Need
• Social Emotional Competence of Children

107. Five Protective Factors that
Strengthen Families
• Parental Resilience
• Social Connections
• Concrete Support in Time
of Need
• Knowledge of Parenting
and Child Development
• Social Emotional
Competence
of Children

108. Nurturing and Positive
Relationships
are the key to mentally healthy children and
adolescents

109. Safe, Stable, Nurturing
Relationships
Safe = free from harm
Stable = a high degree of consistency
Nurturing = compassionate, responsive
caregivers

110. What Does This Look Like?
Someone you turn to:
• Who?
• How you feel?
• What she or he does?

111. Building Supportive Relationships
Starts with Modeling:
• Asking questions and wondering
• Becoming an active listener
• Pointing out the positive
• Being empathetic

112. View “Healing Neen” Here?

113. Building Nurturing
and Attachment
• Observe, attend and
listen to children
• Provide safe and stable
home life
• Model caring behavior
• Respond to child’s needs
• Use positive discipline
• Notice and reinforce
child’s strengths

114. • Set up activities that promote
bonding and attachment
• Acknowledge nurturing behavior
• Provide information on related
topics:
– early secure attachments
– responding to cries
– shaken baby syndrome
– how father’s nurture, etc.
• Be a caring adult or mentor a child

115. Knowledge of Parenting and
Child Development
Why Is This Important?
Parenting is not static
If parents don’t
understand behavior,
they tend to interpret it
as negative
Normal challenges can
lead to frustrations and
harsh discipline

116. Increasing Knowledge
Begin where parents are at:
– discuss hopes and dreams for their children
– identify strengths and build on them
– set up a time or place where parents can
discuss and get information
– provide educational materials, websites

117.
• Educate parents on what to expect next
• Model and teach positive ways to manage
challenging behaviors (routines, limits,
redirection, logical consequences, etc.)
• Attend or set up parenting classes
• Learn/educate others signs of child abuse
• Provide education on ACE’s

118. The power of resilience
moderates the effects of
serious life challenges
and provides hope and
healing

119. The power of resilience moderates
the effects of serious life
challenges and provides hope and
healing.

120. Parental Resilience
Good outcomes in spite of
serious threats, toxic stress
Resilient people:
– are prepared to be
effective in the world
– can adapt to challenges
– are mentally healthy

121. Resilience is
• Feeling connected to
caring family and
community
• Self-regulation skills
• Positive view of self
• Motivation to be
effective in your
environment

122. Begin with yourself
• Take care of own mental health
• Develop healthy coping devices
(regular exercise, reading, listening to
music, etc.)
• Seek out healthy family and
friends for support
• Use community supports
(counseling, substance abuse
treatment, self-help programs, etc.)

123. Building Resilience
• Recognize early signs
of stress and connect
people to resources
• Develop a trusting
relationship and
provide support
• Be a good neighbor
• Look for and point out
inner strengths

124. Teach the
Seven C’s You didn’t CAUSE it
You can’t CURE it
You can’t CONTROL it
You can help take CARE of yourself
By COMMUNICATING your
feelings,
Making health CHOICES, and
CELEBRATING being yourself

125. • Teach skills to
youth
• Plan activities
focusing on
nutrition,
exercising or
relaxation
techniques
• Help children
develop healthy
relationships

126. • Volunteer – reach out and help others
• Be a mentor
• Start a Community Circle of Care
• Model/teach problem solving
skills, planning ahead, goals

127. Social Connections
Network of emotionally supportive friends, family and
neighbors
Important to:
– Ease burden of parenting
– Decrease isolation
– Offer children broader access to supportive adults and
positive role models
– Provide opportunities to help

128. Building Social Connections
• Identify what parents have in place; build on it
• Provide opportunities for parents to get together
- use parents skills, abilities and interests
• Look for community opportunities – faith based,
schools, community centers, support groups
• Provide encouragement and support to try new
groups
• Teach social skills

129. Concrete Supports
in Time of Need
• Food, shelter, basic
services critical to child
well-being
• Link caregivers to
community resources and
extended family
• Work on sustainability

130. Social and Emotional
Competence of Children
• Relate/interact with others
• Regulate own emotions
• Communicate feelings
Delays increase child’s risk for abuse

131. Building Social/Emotional
Competence
• Teach social skills
• Educate parents on importance of
social/emotional skills
• Provide healthy outlets – arts, sensory,
exercise, etc.
• Encourage parents to exchange ideas on
what works
• Take timely action when there is concern

132. 7 Strategies
to Build
Strong
Communities

133. Provide Information
• Educational workshops
• Radio announcements
• Community meetings
• Web-based
• Written material
• Conversations

134. Enhance Skills
Offer workshops/activities designed to
increase skills of participant:
– Training
– Classes
– Consultation
– Counseling
– Team sports,
scouting, 4H

135. Provide Support
• Be a good neighbor
• Offer mentoring or
support groups
• Offer to help
• Spend quality and
quantity time with a
child; read a book,
share a meal

136. Enhance Access and
Reduce Barriers
• Seek grants, build local
collaborations
• Offer food, shelter, seek
professional help if needed
• Link clients to effective faith
based activities, recreation,
parenting classes, domestic
violence shelters/education

137. Change Consequences
• Thank someone for their hard work
• Publicly recognize a community group that
helps strengthen families
• Publish newspaper article highlighting
someone in the community
• Give rewards to individuals or businesses
for helping in the community

138. Change the Physical Design
• Lead/participate in clean-up
effort
• Initiate change to make your
community safer
• Set up place where parents
can gather and get information
• Volunteer to paint a home
• Support your local Child Abuse
Prevention Council

139. Modify/Change
Policy
• Talk to legislators and
philanthropists about
supporting effective programs
• Contribute to child abuse
prevention programs via a tax
check off
• Support positive parenting
programs, and services for
domestic violence and mental
health education

140. Question
• How can we build protective factors in
the families we serve?
• How can we help build resiliency in the
families we impact?

141. If our society is to prosper in the future, we
need to make sure that all children have the
opportunity to develop intellectually, socially
and emotionally.

142. In Summary
• “It is easier to build strong children than to
repair broken men” ~Frederick Douglass (1817-1895)
• “Children make up 25% of our population,
but 100% of our future.” ~Ian Jukes
• Now what?

143. In Summary
“It is easier to build strong children than to
repair broken men” ~ Frederick Douglass (1817-1895)

144. Now What?
• Questions?
• Ideas for utilizing ACE
research in your community?
• What resources do you need?
• What challenges do you foresee?

145. Turn to Your Neighbor
• Share what resonated the most with you
today.
• How are you going to use this
information?

146. To Get Involved Contact
Marcia Stanton, Child Abuse Prevention Coordinator,
Phoenix Children’s Hospital
mstanto@phoenixchildrens.com
Joan Shaffer, Program Manager,
Southwest Human Development
jshaffer@swhd.org

149. Parenting Resources
• 1-877-705-KIDS (5437) - Birth to Five Parenting
Questions Helpline
• 1-800-4-A-CHILD (422-4453) - Crisis Line for
emotional needs, info on child abuse/neglect
Also go to: www.childhelp.org
• www.azpbs.org/strongkids
• www.apa.org/books
• www.pbs.org/parents/childdevelopment
• www.cdc.gov/parents

150. Information & Resources
• ACE Study findings and information
- www.acestudy.org or www.cdc.gov
• ACEs Too High – www.acestoohigh.com
• National Scientific Council on the
Developing Child at Harvard University
- www.developingchild.net
• SAHMSA – Early Childhood Trauma Resources
http://www.samhsa.gov/children/earlychildhood
mat.asp

151. More Information & Resources
• National Center for Trauma-Informed Care –
www.mentalhealth.samhsa.gov/nctic
• National Child Traumatic Stress Network –
www.nctsnet.org
• Center for Study of Social Policy - strengthening
families and protective factors – www.cssp.org
• Center for Injury Prevention and Control –
www.cdc.gov/violenceprevention
• American Psychological Assn – Resilience
Guide - http://www.apa.org/helpcenter/road-
resilience.aspx

152. More Resources
• 3 ½ hour ACE Online Course - $29 -
http://www.fpc.wa.gov/acecourse.html
• Ready Nation– http://www.readynation.org/
• Resiliency Trumps ACEs –
http://www.resiliencetrumpsaces.org
• Healing Neen - http://healingneen.com/
• NCAN Resource Booklet -
http://www.childwelfare.gov/preventing/preventio
nmonth/guide2012/
• ACE Response Network -
http://www.aceresponse.org/

153. Works Cited
ACE Study:
The CDC Adverse Childhood Experiences (ACE) Study homepage presents a wealth of
information on the ACE Study including a complete bibliography of ACE Study
publications by topic area (http://www.cdc.gov/ace/index.html).
Safe, Stable, Nurturing Relationships:
The CDC National Center for Injury Prevention and Control, Violence Prevention has
many resources on the prevention of child maltreatment
(http://www.cdc.gov/violenceprevention/) and promoting nurturing relationships
between children and caregivers
(http://www.cdc.gov/violenceprevention/pdf/CM_Strategic_Direction--Long-a.pdf ).
Early Brain Development:
The Center for the Developing Child at Harvard University has a wealth of the latest
research and resources on the science of early childhood
(http://developingchild.harvard.edu/ ).
The Zero to Three Institute has many resources on the impact of trauma and building
resiliency in young children
(http://www.zerotothree.org/maltreatment/trauma/trauma.html ).
First Things First has great info on the science of early brain development
(http://www.azftf.gov/why/evidence/pages/brainscience.aspx ).

154. Works Cited
Economic Costs:
CDC Injury Prevention Center includes well-researched articles on the cost of child abuse
(http://www.cdc.gov/ViolencePrevention/childmaltreatment/EconomicCost.html ).
The Heckman Equation has compelling resources for upstream solutions to societal
problems by investing in early and equal development of human potential
(http://www.heckmanequation.org/content/heckman-101).
Protective Factors:
The Child Welfare Information Gateway has a wealth of well-researched resources for
protecting children and strengthening families
(http://www.childwelfare.gov/can/factors/protective.cfm ).
Environmental Prevention Strategies:
The Community Anti-Drug Coalitions of America website includes resources for effective
community problem-solving strategies
(http://www.cadca.org/files/Beyond_the_Basics_EnvironmentalStrategies.pdf ).
The 7 Cs Creed:
National Association for Children of Alcoholics has a downloadable kit for professionals
on tips for working with children of alcoholics (http://www.nacoa.org).

155. Thank You for Helping Make Our
Community Strong!